Chronic prostatitis - symptoms and treatment

Symptoms of chronic prostatitis are often mild and treatment is not carried out at the initial stage. However, the problem can be solved if you take it seriously.

What it is

Many patients find out what chronic prostatitis is when they visit a doctor for a completely different reason. Meanwhile, this disease is very dangerous and is a long-term inflammatory process that occurs in the prostate. If left untreated, serious complications can occur: impotence, infertility, vesiculitis, prostate cysts, adenomas and prostate cancer.

There are several forms of the disease:

  • acute bacterial prostatitis, caused by the penetration of infectious pathogens into the prostate. Characterized by typical pain in the lower abdomen and when urinating;

  • chronic bacterial prostatitis, which, along with the clinical picture of the acute form of the pathology, is accompanied by the presence of bacteria and an increase in the level of leukocytes in urine and prostate secretions;

  • chronic prostatitis, a consequence of a previous bacterial form of the disease with ineffective treatment or its absence;

  • Asymptomatic inflammatory prostatitis, characterized by the absence of any symptoms, but manifests itself during laboratory diagnostic methods.

More than 90% of cases of chronic nonbacterial prostatitis are asymptomatic, leading to a delay in treatment.

Is it possible to cure

The diagnosis itself indicates that the disease has been progressing in the body for a long time. It is often difficult for men to seek medical attention for such an urgent problem until the situation becomes critical. Meanwhile, the sooner a man consults a doctor (at the first signs of poor health), the more effective the treatment will be and the higher the probability of completely getting rid of the disease. In its advanced form, chronic prostatitis is almost impossible to cure, but with proper and regular treatment, the symptoms will become less pronounced. This is why it is so important to consult a doctor in a timely manner.

Causes

The disease occurs in men aged 20 to 50 years old and depends on a number of prerequisites:

  1. Infectious pathogens. They enter the prostate in several ways:

    • ascending (along the urethra);

    • descending (through infected urine);

    • lymphogenic (through lymphatic channels);

    • hematogenous (through the blood).

    Examples of pathogenic microflora that cause the bacterial form of prostatitis are staphylococci, Escherichia coli, enterococci, Proteus, pathogens of viral, fungal and parasitic nature, as well as chlamydia, gonococcus, gardnerella and others.

  2. Disruption of normal blood circulation in the pelvic organs. This can be due to a sedentary lifestyle, sedentary work (drivers, office workers) and poor diet. As a result, congestion and swelling occur in the prostate tissues and incomplete expulsion of secretions from the organ cavity is observed. All this leads to partial or complete dysfunction of the gland.

  3. Prolonged sexual abstinence or practice of interrupted sexual intercourse. These actions also cause inflammatory processes in the prostate.

  4. Accompanying illnesses. First of all, these are pathologies of a urological nature: cystitis, urethritis, pyelonephritis, untreated acute prostatitis. However, the cause of chronic prostatitis can also be other diseases: chronic bronchitis, pneumonia, sinusitis, etc.

  5. Frequent and prolonged stay in the cold, in conditions of high ambient temperature or high humidity, constant psycho-emotional stress.

Symptoms

The clinical picture of chronic prostatitis is poorly expressed at the initial stage. As a rule, a man does not feel any discomfort or does not pay attention to the appearance of signs of the disease if they do not interfere with a normal lifestyle. Over time, the general condition worsens and is accompanied by the following symptoms:

  1. The appearance of pain in the perineum, genitals and groin. The pain may be mild, aching, or quite severe during urination, defecation, after intercourse, and during ejaculation. Often the pain syndrome spreads to the sacrum, anus, scrotum and testicles.

  2. Trouble during urination and defecation. In the first case, the process is characterized by frequent and painful urges and burning in the urethra. The presence of threadlike formations is observed in the urine. During defecation, discharge from the urethra is possible, which indicates insufficient tone of the prostate.

  3. Sexual function disorders. In men suffering from chronic prostatitis, a decrease in libido, unstable erection or its absence, pain during and after sexual intercourse, hemospermia and infertility are observed.

  4. Poor sleep, irritability, increased nervousness, fatigue, depression.

  5. Increased body temperature. It can be observed during an exacerbation of the disease and have minor deviations from the norm.

Symptoms may not appear all at once, but may be constant.

Diagnostic

Diagnostic studies make it possible to refute or confirm a suspected diagnosis, determine what type of disease it is and to what extent it is possible to cure it.

Ultrasound for chronic prostatitis – healthy (left) and inflamed (right) prostate

The main diagnostic procedures are:

  • general urine analysis;

  • analysis of prostate secretion for the presence / absence of pathogenic microflora, as well as to determine deviations of physiological parameters from normal values (increase in the number of leukocytes, etc. );

  • bacteriological culture of urine and taking a smear from the urethra;

  • a urine sample in three glasses to determine the area of localization of inflammation;

  • analysis to identify pathogens of genital tract infections;

  • Prostate ultrasound;

  • study of spermogram data, MAR test (for reproductive anomalies);

  • urodynamic and endoscopic examinations;

  • determination of prostate specific antigen (PSA).

Treatment of chronic prostatitis

The answer to the question of how to treat chronic prostatitis depends on the severity of the pathology and its type. The disease requires an integrated approach to its elimination or stable relief of symptoms.

Medical treatment

This involves taking medications from the following groups:

  1. Antibiotics, which are necessarily prescribed when diagnosing a bacterial form of pathology. However, such treatment may also be indicated for chronic nonbacterial prostatitis if a persistent positive effect is observed. Medicines from the groups of penicillins, cephalosporins, tetracyclines, aminoglycosides and fluoroquinolones are taken in strict accordance with the doctor's instructions for at least two weeks.

  2. Antispasmodics that help eliminate painful spasms of the perineum.

  3. Anti-inflammatories, analgesics.

  4. Alpha1-blockers used to reduce prostate hypertonia and normalize motility.

  5. Immunostimulating drugs.

The treatment regimen is selected individually based on the features of the diagnosis and intolerance to individual drugs (if any).

Non-drug treatment

In this case, the positive effect of therapy is achieved by a physical effect of a different nature on the diseased area. Patients may be prescribed:

  1. Prostate massage. It activates the complete expulsion of secretions from the prostate, improves blood circulation and normalizes the tone of the organ. Massage combined with antibiotics is particularly effective in treating chronic bacterial prostatitis. However, there are contraindications to its use if the patient is diagnosed with:

    • acute bacterial prostatitis;

    • concomitant diseases of the gonads (vesiculitis, coperitis);

    • the presence of stones in the prostate;

    • prostate cysts;

    • HBP;

    • cancer of an organ or suspicion thereof;

    • prostate abscess;

    • hemorrhoids, rectal fissures and other disorders.

  2. Electrophoresis. The physiotherapy procedure involves a therapeutic effect on the pathological area with a weak electric current (no more than 50 μA). In this way, recovery reactions are stimulated, pain is relieved and blood flow in the gland tissues is optimized. Electrophoresis promotes the deep penetration of antibiotics into the structures of the prostate, thereby increasing the effectiveness of their action.

  3. Ultrasound. The method is widely used in the treatment of chronic prostatitis, as it has a pronounced anti-inflammatory effect, restores sexual function and removes pain. Prostate tumors are successfully treated using ultrasound.

  4. Ultraphonophoresis is the use of ultrasound therapy in combination with medications. This method allows drugs to penetrate the deep layers of the affected organ and act there as effectively as possible.

  5. Magnetotherapy. The physiotherapy procedure has a comprehensive restorative effect on the genitourinary system, improves metabolic processes and neurogeneration.

  6. Laser magnetic therapy. Laser exposure also effectively treats the manifestations of the disease, eliminating the risk of possible complications.

  7. Inductometry is the exposure to a high frequency alternating magnetic field.

  8. Instillations into the urethra, mud therapy, therapeutic enemas, hot baths.

Physiotherapy in combination with drug treatment allows you to achieve a long-lasting therapeutic effect and, in most cases, completely overcome the disease at the initial stage.

Surgical intervention

Indicated in cases where it is impossible to help the patient with other methods.

  1. Prostatectomy is the partial or complete removal of the prostate while maintaining erectile function.

  2. Transurethral resection (TUR) is an operation to excise or remove invaded glandular tissue. Prescribed for prostate adenoma or cancer.

  3. Laser surgery. The operation involves removing tissue from the affected organ using a laser beam. In this case, the blood vessels are "sealed", thereby eliminating bleeding.

  4. Drainage of a prostate abscess. This surgery extracts pus from the glandular cavity using a rubber drainage inserted into the perineum or rectum by cutting the skin tissue.

  5. Transurethral incision of the prostate. Surgery involves making several incisions in the prostate to relieve pressure from the affected organ on the urethra and restore urination.

After surgery, the patient requires rehabilitation, the time interval of which, depending on the type of surgical intervention used, varies from 2-3 days to several months.

Folk remedies

Herbal remedies are also effective drugs in the complex treatment of chronic prostatitis. For these purposes, tinctures, decoctions, food mixtures or ointments are used, which include:

  • pumpkin seeds;

  • aspen bark;

  • hazel leaves and bark;

  • chestnut shells;

  • parsley;

  • honey, propolis;

  • Kalanchoe etc.

Regular use of medicinal plants helps to eliminate unpleasant symptoms, restore impaired functions and have a long-term preventive effect.

Chronic prostatitis is a disease that should be paid attention to at the first signs in order to eliminate dangerous complications and cure it in time.